Recently told I need valve replacement but may not be able to take warfarin

[pellicle]

How do I know you’re the real Chuck C and not just trying to trick us into a false sense of security?

wait, how do I know I'm me?
I just took a selfie in the bathroom and I think I've been abducted

 

[Protimenow]

Yes, I guess you're just a floating arm.

It's a shame how a once important thread devolved. I'm glad to see that it mostly returned to the original topic.

(The other nine of me agree).

 

[pellicle]

I’ve been advised to consider the bovine valve for now, and a mechanical one next time. The comment someone made about risks of each surgery does worry me, especially regarding the effect on cognitive function, so I think I have some more research to do!

my present view on the topic is this:
If you have no desire to bear children soon, then there is no pressing need to avoid anti-coagulation; however if you feel you would not in your present frame of mind be a good candidate for taking seriously ACT (monitoring weekly, having a good system setup to minimise errors in taking and forgetting taking) then perhaps there is as much risk from mismanagement of ACT as there is in second surgeries.

I don't see your age (like, say year of birth) in your "about" (and I'm not wanting to fish through every post you've made to try to see if you've mentioned it) which makes it hard to be sure of what I'm saying. Presuming that you're between 40 and 60 then I'd say the approach of "kick the can" can bring benfits as I mentioned here:

I believe now (more so than I did 10 years back) that having a bio as your first intervention can be a good thing. Its good because it transitions you from being able to recite data to actually possessing experiential learned knowledge. You grok it if I may use that word.

During recovery you become aware of what all those words people said mean when over (say) 10 to 15 years you go through recovery, to yearly examinations, to eventually turning the corner when Structural Valve Degradation (SVD) becomes an actual in your personal face reality. I recommend you read this about SVD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209403/
You'll experience it and I believe that if you don't experience it you may well always wonder if that was what really happened. When people close to me have died suddenly and unexpectedly there was always some nagging part of my personal unconscious half expecting to see them ... this went on for years. This never happened to me with those who I saw getting sick, went to sit beside them during Chemo, went through remissions with them and then eventually there was no remission and I went to see them in their last days at the hospital and finally went to their funerals.

So based on what you've said, unless you decided otherwise I would suggest that you get a bioprosthesis and consider it not just "kicking the can down the road" but part of your personal life journey.

Remember, my journey started when I was about 6, with all the hospital visits (which increased in frequency) and then an OHS at 10, a (then called) catheter examination (as the technology was introduced) of how the repair was going, then at 28 got somebody elses valve, then at 48 (with the development of an Aortic Aneurysm) chose a mechanical valve with my bental.

I've since learned a lot about all of that and what it entailed and what I was lucky to avoid. I did however have a bit of a bumpy first year after an infection from the OHS #3 emerged.

WRT

me, especially regarding the effect on cognitive function,

I'd say that such a risk is minor and directly related to your age and the duration of time spent on the cross clamp. As you know I've had 3 and so after my redo (#2) I noted some time needed to get back into form. I was at the time in the middle of my degree in IT. I managed to graduate (with good marks) and work in the sector for 20 years

HTH

 

[MdaPA]

but my surgeon and cardiologist believe it’s probably too risky to consider pregnancy on warfarin.

There have been a few women who have posted in this forum that they have had successful pregnancies while taking warfarin and/or with mechanical valves. Suggest you seek a second opinion on this, perhaps with a high-risk OBGYN, as this is a big decision.

I also have an underactive thyroid and apparently warfarin and levothyroxine don’t work well together, but I’m yet to research this further.

My wife is on warfarin and stopped taking Levothyroxine (generic), not because of any known interaction, but because she experienced heart palpitations. She switched to Synthroid (brand) and the palpitations ceased.

 

[pellicle]

Yes, I guess you're just a floating arm.

well thats good, for a second I was concerned I'd been grafted onto a vampire

 

[Chuck C]

How do I know you’re the real Chuck C and not just trying to trick us into a false sense of security?

I'm not even convinced that I'm the real Chuck C.

I've been reading up on Gilbert Harmon and am more and more convinced that I'm just a brain in a jar and all of you are just part of electrically generated imaginary memories.



I was going to shoot back, asking you how I know that you're the real Superman. Then I remembered that you presented photographic evidence that you went rim to rim at the Grand Canyon. Definitely the real Superman (at least as far as my imaginary brain in a jar universe is concerned )

 

[pellicle]

I'm not even convinced that I'm the real Chuck C.

I've been reading up on Gilbert Harmon and am more and more convinced that I'm just a brain in a jar and all of you are just part of electrically generated imaginary memories.



I was going to shoot back, asking you how I know that you're the real Superman. Then I remembered that you presented photographic evidence that you went rim to rim at the Grand Canyon. Definitely the real Superman (at least as far as my imaginary brain in a jar universe is concerned )

 

[dornole]

Hey Zara, someone just posted that their wife gave birth with a mech valve - maybe you can pm them? I will try to find that thread since it’s recent.

I gave birth with a stenotic native mitral valve (did not know I had it prior) and that was extremely sketchy, bad option. I would agree to consult a high risk ob gyn (perinatalogist) as you decide what to do about your valve choice. They would have a better grasp on managing a mech valve pregnancy than a cardiologist would.

 

[dornole]

It’s Shiv who just posted again - baby is 3 now.

 

[slipkid]

The talk above about the logical conundrum reminded me of this favorite scene from Star Trek that I first saw as a kid and never 4got..

 

[Survived03]

I have already gone through one bowl of popcorn on this string. 8>)

 

[pellicle]

I have already gone through one bowl of popcorn on this string. 8>)

then its been a good thread

 

[Zara0006]

Hey Zara, someone just posted that their wife gave birth with a mech valve - maybe you can pm them? I will try to find that thread since it’s recent.

I gave birth with a stenotic native mitral valve (did not know I had it prior) and that was extremely sketchy, bad option. I would agree to consult a high risk ob gyn (perinatalogist) as you decide what to do about your valve choice. They would have a better grasp on managing a mech valve pregnancy than a cardiologist would.

Thank you! I will see if I can consult a high-risk ob gyn for advice! Cardiology don’t seem to have detailed knowledge in this area as I guess they see mostly older patients.

 

[pellicle]

...Cardiology don’t seem to have detailed knowledge in this area as I guess they see mostly older patients.

something I often say here

 

[Varago33]

You’re giving a lot of advice for someone who doesn’t believe anyone should be following it.

Superman very good comment

 

[Astro]

Hi Zara,

Hope you are going well. Have you decided tissue or mechanical yet?

Warfarin is a big challenge with pregnancy. Warfarin creates birth defects so clexane injections are generally required throughout the pregnancy. Full anticoagulation excludes epidurals or spinal options for delivery and increases risks of big bleeds. A tissue valve is much easier with pregnancy. I suspect that your doctors have already discussed these issues with you.

If you have a tissue valve, you can see how long it lasts. If you are lucky with how long it lasts, a TAVI might be an option when it wears out.

Good idea to get more than one medical opinion if you feel that they are not considering all the factors.

Lots of people have pregnancies with valve replacements so you won’t be your medical team’s first.

Regards,

Astro

 

[Zara0006]

Hi Astro, thank you for your input, it’s much appreciated! I have not yet decided 100% but I am leaning towards going for a tissue valve as you suggested, and then just praying that by the time I need another surgery there’s something better available. I keep wondering whether it’s all worth it, having to deal with a second surgery…at this rate, I think I might end up just deciding the day before!

 

[tommyboy14]

Hi Zara,

having a baby is an excellent reason to go Tissue valve at your age. But please know that valve technology evolves very slowly, so choosing tissue because you want to benefit from better technology later is not a wise strategy, because there may not be better technology later. It is best to minimise OHS if you can...

 

[dornole]

You could get lucky, your odds of the tissue lasting are pretty low because of your young age and at that point when you are still very young they’re very unlikely to do a taco. I would make the assumption that you are definitely having a second OHS to put in a mechanical valve. Did you ever get to talk to a perinatologist / high risk obgyn? What did they say?

 

[dornole]

You could get lucky, your odds of the tissue lasting are pretty low because of your young age and at that point when you are still very young they’re very unlikely to do a taco. I would make the assumption that you are definitely having a second OHS to put in a mechanical valve. Did you ever get to talk to a perinatologist / high risk obgyn? What did they say?

You could get lucky, your odds of the tissue lasting are pretty low because of your young age and at that point when you are still very young they’re very unlikely to do a taco. I would make the assumption that you are definitely having a second OHS to put in a mechanical valve. Did you ever get to talk to a perinatologist / high risk obgyn? What did they say?

Unlikely to do a TAVI, lol. Though, I do stand by my former statement

“they’re very unlikely to do a taco.”